During this week, USAID is focusing on mothers and on how maternal health is critical to achieving its global health goals. Partnerships between the private sector and NGOs, foundations, associations, and others have allowed USAID to maximize its health impact around the world.

The death of a mother profoundly affects the health and well-being of her children. When a mother dies, her children are less likely to survive. If a mother dies in childbirth, her child is 10 times more likely to die before reaching age one.

A mother and her child in India. Photo credit: USAID

While maternal mortality remains unacceptably high throughout the developing world, a number of USAID-assisted countries have achieved significant reductions in maternal deaths from pregnancy-related causes. For example, several countries have already achieved Millennium Development Goal (MDG) 5 (PDF)—reducing maternal mortality by three-quarters between 1990 and 2015—including the following countries in which USAID works:

Romania (achieved an 84% reduction, from 170 to 27 maternal deaths per 100,000 live birth)

During the 24 hours of Mother’s Day, some 720 women—one every two minutes—died in pregnancy or childbirth—and about 8,000 newborn babies died. The 24-hour period of labor and delivery and the first day of life for babies, in particular, is the most dangerous time period for mothers and babies. Most maternal and newborn deaths during this time period could be prevented, however, with critical, lifesaving interventions, including:

Meeting unmet need for family planning could prevent more than 100,000 maternal deaths annually by giving couples the ability to decide when and how many children to have. Expanding access to family planning will help women bear children at the healthiest times so that mother and child are more likely to survive and stay healthy.

USAID programs work to ensure women have access to a wide range of voluntary family planning methods ranging from CycleBeads® (a natural family planning method) to oral contraceptives and other short term as well as long-acting methods, from which a woman can choose. Expanding access to long-acting reversible contraceptives and permanent methods(LARCs and PMs) is particularly important. An article published in the Global Health: Science and Practice Journal (co-published by USAID and the K4Health Project at the Johns Hopkins Bloomberg School of Public Health Center for Communication Programs) explains that if 1 of 5 women in sub-Saharan Africa who were currently using pills or injectables switched to contraceptive implants, more than 1.8 million unintended pregnancies would be averted in 5 years, resulting in 10,000 fewer maternal deaths. Although use of implants worldwide remains low, they are increasingly popular and in high demand when they are actually available in family planning programs.

Not surprisingly, many programs are focusing on increasing access to family planning in countries with low contraceptive prevalence, such as in Africa where modern method use is at 23%. But family planning programs in countries with relatively high contraceptive prevalence also could have the potential for improvement. For example, women in Indonesia have, on average, 2.6 children, and modern method use is at 58%. However, contraceptive prevalence has been stagnant since the 1990s and the method mix is skewed toward short-acting methods, even though Indonesian couples are more likely to want to limit births. Nearly 8 in 10 modern method users rely on injectables and pills. Meanwhile, use of IUDs has dropped dramatically over the years, from 13% in the early 1990s to only 4% today, and use of implants and sterilization is at about 3% each.

The K4Health Project is implementing the Improving Contraceptive Method Mix (ICMM) Project to better understand the situation on the ground. Why has use of certain long-acting methods, such as IUDs, dropped over time? Do women know about LAPMs? Are they interested in using these methods?

This information will help inform the design of an integrated advocacy and knowledge management intervention—informed by Advance Family Planning-Indonesia’s advocacy methodology—in 6 districts in East Java and West Nusatenggara. ICMM will support the availability of a broader range of contraceptive methods for women and couples, with the ultimate goal of improving maternal health in Indonesia. The innovative project, funded jointly by USAID and AusAID and implemented by K4Health in collaboration with the Cipta Cara Padu Foundation, the Center for Health Research at the University of Indonesia (CHR-UI), the Indonesia Ministry of Health, and the National Population and Family Planning Board (BKKBN), is a unique partnership that leverages valuable resources and complementary skills and capabilities of various stakeholders.

With knowledge partnerships such as these and others designed to save mothers and babies through family planning, combined with improved services for pregnant women, perhaps Mother’s Day celebrated in the U.S. will one day become an international celebration event for women all around the world, if not in name, then at least in practice.

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

In March, the United States Agency for International Development (USAID) and its partners announced the winners of its Counter-Trafficking in Persons (C-TIP) Campus Challenge Tech Contest– a global call to college students to develop creative technology solutions to help prevent human trafficking. USAID invited some of the contest winners and participants to Washington, D.C., this April to participate in the White House Forum to Combat Human Trafficking and discuss their winning concepts with USAID staff and partner organizations. This is a blog about their trip to Washington.

Popular culture has pegged Washington, D.C., as the home of the bureaucrat, a city where red tape rules. Our time in the capital is a testament to the narrowness of this idea. While we don’t pretend that we got a full picture of the federal government during our brief stay, the experiences we shared speak to a government that still has compassionate members and is made up of individuals that see love as “central to this fight.” This was a phrase that Ambassador Luis CdeBaca used as he spoke during the presentation of the President’s Advisory Council on Faith-Based and Neighborhood Partnerships report on “Building Partnerships to Eradicate Modern-Day Slavery.” This event was one of many meetings we attended during our two days, a time spent better understanding government intervention in human trafficking and developing further the ideas that were awarded first and second place prizes in the USAID C-TIP Campus Challenge.

Our two winning concepts – AboliShop a web browser application that helps online shoppers make smart choices by alerting them to products that may have forced or exploited labor in their supply chains, and a Mxit trafficking hotline (PDF) that marries Africa’s largest social network with existing hotline technologies – were tuned and refined by a variety of trafficking experts while we were in Washington. This refinement process has seen us through to the other side, where we are now in a position to move toward making these products available for public use in the near future.

During our time in Washington, USAID connected us with a variety of groups, from religious leaders to large corporations to passionate activists, all aiming to end trafficking on a global scale. We saw much of the public sector’s commitment at the White House Forum to End Human Trafficking and the private sector’s commitment at the Google announcement of their Global Trafficking Hotline Network. Our discussions with these groups made a difference in the future of AboliShop and the Mxit trafficking hotline and also reshaped the way we will be involved in the fight on a personal level.

As for the future of our projects, we want to see AboliShop become a common, not a niche, experience for online consumers, which will only be possible with the energy and resources of groups willing to work alongside us. Africa is in desperate need of trafficking hotline resources, as the existing hotlines are both sparse and limited by a variety of factors. We hope that we can be part of the solution to this problem, joining the organizations already working on the ground to grow the African trafficking hotline network. Keep an eye out for news from AboliShop and Mxit in the days to come.

During the month of May, IMPACT will be highlighting USAID’s work in Global Health.

Few things really worth having are easily obtained. This old saw, though well worn, applies perfectly to vaccines. And it bears repeating as we approach HIV Vaccine Awareness Day—especially in light of the recent termination of HVTN 505, a clinical trial testing whether a candidate vaccine regimen could prevent HIV infection or slow progression to AIDS. The trial was halted when it became clear the regimen would fall short on both goals.

This is disappointing news; yet history has taught us that such setbacks are par for the course in vaccine development. Indeed, most of the vaccines now lauded as lifesavers—not least of which is the storied polio vaccine—came to us only after several decades of research peppered with setbacks. This is the nature of the effort: vaccine researchers learn through informed trial and error what works, and what does not, and use that knowledge to hone their strategies.

An HIV-positive child at the Muranga District Hospital in Kenya waiting for treatment. Photo credit: Casey Kelbaugh, Int’l Center for AIDS Care and Treatment Programs, Columbia Univ. School of Public Health

Most importantly, we must emphasize that the termination of HVTN 505 occurs against a backdrop of remarkable progress in HIV vaccine development. Another large trial, completed in Thailand four years ago, demonstrated that HIV can be prevented by vaccination. Although the protection was modest, researchers are now working to improve on those results. Further, some 30 early-stage HIV vaccine trials are currently being conducted around the world—and many researchers are advancing novel vaccine candidates.

With the support of donors, especially USAID and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), IAVI and its partners are contributing to these efforts on several fronts, focusing primarily on vaccines against HIV subtypes that circulate in developing countries and emphasizing novel vaccine strategies.

A trial we recently initiated in Kigali, Rwanda, for example, tests a vaccine candidate that has been engineered to persist in the body, which we expect will boost the potency, durability and breadth of immune responses that can destroy HIV-infected cells. The candidate is devised to elicit those responses in the mucosal tissues that line inner body cavities, such as the gut, where sexually transmitted HIV establishes a beachhead in the early stages of infection. The trial will also be conducted with IAVI’s partners in London and Nairobi. With support from USAID and PEPFAR, through IAVI, the Kenya AIDS Vaccine Initiative (KAVI) in Nairobi has built the capacity to systematically evaluate immune responses in mucosal tissues. This capability will contribute to KAVI’s growing prominence as a center of excellence in clinical research.

Over the past couple of years, IAVI and other organizations have also made significant progress toward the design of vaccines to elicit broadly neutralizing antibodies against HIV. Such antibodies would stop HIV from infecting its target cells in the first place. Researchers at and affiliated with IAVI have analyzed the structure of such antibodies, charted their evolution in the body and, most recently, shown that it might be possible to kick-start their production with a tailored vaccine.

We suspect that both cell-killing and blocking antibody responses will be needed to prevent HIV infection by vaccination. Though we will probably face some setbacks advancing such strategies, researchers are making brisk progress toward that goal. All the evidence today suggests that, if we persevere, it is just a matter of time before HIV vaccines become available. That should serve as a source of inspiration to all of us on this HIV Vaccine Awareness Day.

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

Today USAID hosts its annual Small Business Conference at the Ronald Reagan Building in Washington. Below are some tips for growing your small business with USAID from Social Impact, recipient of the 2012 USAID Small Business of Year Award.

This week Social Impact (SI) is proud to receive USAID’s inaugural Small Business of the Year Award, based on our growth and service to support USAID in Washington and overseas to accomplish its international development priorities.

It seems like just the other day that SI started as two-person company in 1996 with our same mission and vision—to make international development more effective in improving people’s lives. As the two founders, Pat Hanscom and I started SI with a small virtual team of like-minded individuals—people who cared about development and thought that they could help big international agencies, like USAID and the World Bank, to become more results-oriented and people-centered in their approaches to working with developing countries. These are really the very same principles central to USAID Forward and USAID’s strategic plan. Yes, earlier versions of this thinking go way back in USAID and the international development community and when we created Social Impact we successfully spotted these needs and saw them as growth areas.

Small business owner Arnoise Clerveaux (in back) sits in her shop in Cap-Haitien, Haiti, on March 24, 2011. Photo credit: Kendra Helmer/USAID

When SI started out there were few opportunities for small businesses to get into the game. We had luck marketing SI and developing smaller contracts directly with USAID missions where we knew people and where we correctly identified opportunities to market SI’s services in project design, strategic planning, organizational capacity building, gender integration, monitoring and evaluation and participatory development. During these earlier years “relational” marketing produced a good result for us though it involved lots of meetings and hoof work. Through some of our earlier work we helped USAID create some of its good practices in participatory approaches to project design and strategy development in the field.

By the late 1990s things really got tough as USAID began to bundle all most all of its work into large Indefinite Quantity Contracts (or “IQCs”). These IQCs were hard barriers for micro and small business to break through and most of the work was reserved for USAID’s big business partners–“the usual suspects.” SI and many other small business saw token participation in USAID projects as small business subcontractors (or “subs”) but few opportunities to gain meaningful work as prime contractors, even with our demonstrated and growing capabilities.

After diverse efforts to work with development banks, UN agencies and other donors, we managed to win our first USAID IQC in 2003 with USAID’s Office of Transition Initiatives. We got to know them and they to know us through some conferences and strategy sessions that we facilitated as a sub. Our work with OTI in fragile states put us on the map with USAID and give us some additional “street cred”, especially with USAID’s emerging focus on fragile states.

About this time we grew bolder and started to advocate with our colleagues at OSDBU for more small business opportunities. When new RFP’s came out that had no opportunities for small business we’d say, “Hey, we’re here and we have capabilities to do this!” “Why doesn’t USAID follow through on its Congressional requirements to do more with small business?” In some cases we even wrote to the House Small Business Committee and said “USAID needs to be more accountable in meeting it small business goals”. Bottom line is that our advocacy—and that of other small businesses- helped to call more attention to our capabilities and those of the small business community to support USAID. USAID’s Office of Small and Disadvantaged Business Utilization (OSDBU) became our trusted ally and advocate during this time.

Things really started really started to change dramatically with the new OSDBU team led by Mauricio Vera, Director and Kimberly Ball, Deputy Director. They had a clear mandate, a strong sense of purpose, a great sense of agency politics and contracting procedures, and top-level support from the Administrator to create additional opportunities for small business at USAID. Through their peaceful and persistent persuasion, Contracts Review Boards were set up, Bureaus and Contracting Officers became more accountable for creating small business opportunities and the pressure was truly on to change things for the better.

Now USAID has an “A-” on the SBA Scorecard and most of the new generation of IQCs contain solid set-aside provisions for small business. And we’re even beginning to see some USAID missions create small business opportunities (in large part due to OSDBU’s “road shows” in the field). What was once a barren landscape for small businesses now looks pretty fertile. I can’t imagine a better time for small businesses to get started with USAID.

Based on our experiences here are some tips for growing your small business with USAID:

Know your core capabilities and advocate for them through OSDBU. Get to know your OSDBU colleagues and keep them informed about your capabilities and growing successes with USAID.

Get to know USAID as your customer including its current priorities, strategy documents and quality standards in the areas of your work.

Focus on the quality of your work. USAID’s rating of the quality of your work in Customer Performance Reports or “CPRs” is critical to your landing new business.

Find a capable medium or large sized business or two who will subcontract with you so you can get into the game and establish your credentials with USAID. Look for business who are willing to give you a well-defined piece of the action rather than just “blowing kisses” in your direction.

As resources permit, grow your management team to include people who have successful experience working with (or in) USAID in your areas of expertise. This will give you tremendous insight on how to win work and how to perform at the high level of quality that USAID expects.

Don’t grow too quickly. Growing purposefully–while not overextending your capabilities–will allow you to build your experience while minimizing the risks for your company and for USAID.

Enjoy and appreciate the value of your work! When you step back from this all, there are few industries that enable you to produce a double or triple bottom line of a financially viable company while contributing to global social wellbeing and a more sustainable environment!

During the month of May, IMPACT will be highlighting USAID’s work in Global Health. From May 11-17, we will be featuring the important role of mothers and partnerships in Global Health.

In the last 23 years, global mortality rates have decreased by 47 percent. With funding from international governments and non-governmental organizations, developing countries across the globe have received unprecedented aid in the form of education and healthcare support to decrease mortality rates.

Join My Village (JMV), a program of CARE in partnership with General Mills and Merck, is working to resolve this issue by building awareness online and providing on-the-ground programming that includes support groups for men and women as well as community engagements to reduce misconceptions about pregnancy and maternal health. JMV helps to lift women and girls out of poverty through education while also providing sustainable improvement in maternal and newborn health through effective service delivery and women’s empowerment initiatives. The programs are having a remarkable impact on communities in India by changing the behavior and attitude of whole communities around the treatment of women.

Along with working to uplift women, JMV is has also made a point to engage men in these communities. Men have a larger say in decisions that ultimately affect women’s economic, educational and reproductive health. To ensure that the women have a conducive and supportive environment at home, their husbands are invited to participate in the interactive meetings.

Recently, we heard from a young husband and wife participating in the JMV program in Uttar Pradesh, India. After going through a difficult first pregnancy where the mother did not receive prenatal care, the young woman almost lost her life and her baby. Of the second pregnancy, her husband said, “Though that incident taught me the risks involved in home deliveries, today’s meeting taught me how to be better prepared even before the child arrives. My wife stopped taking her iron tablets as she said they made her nauseous. I didn’t bother much about it until I came here today and learned how important they are for both the child and my wife. Now I will ensure she takes them at the appropriate time to avoid uneasiness. Planning for the future is another critical thing I learned, and I will start saving for the child right away.” The couple, happy to have attended the meeting, feel that they are now better equipped for the birth of their second child.

Preventing maternal deaths not only saves women’s lives, it can positively impact families and whole communities. When a mother dies, her family oftentimes breaks apart and her children are less likely to go to school, receive immunizations against diseases and eat nutritionally sound diets. By equipping women and their partners with lifesaving information, women will bear children at the healthiest times so that mother and child are more likely to survive and stay healthy.

Through these outreach programs, JMV encourages communities to be supportive of the health, education and empowerment of women and girls. To learn more about Join My Village and its partners please visit www.joinmyvillage.com.

Akanksha Nigam is a Media Officer for Join My Village, a program of CARE.

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.

Today USAID hosts its annual Small Business Conference at the Ronald Reagan Building in Washington. Below are some tips that a small business partner offer to other organizations interested in working with USAID.

As the co-owner and co-founder of Sonjara, a woman-owned IT firm that specializes in IT for international development, I am often asked, “How do we get work with USAID?” The reality is — it isn’t easy but it IS possible.

USAID is looking for new, innovative partners who come with great ideas and real experience that can be applied to international development. For example, do you work in rural/underserved environments in the U.S.? Do you do a lot of capacity building and training of local civil society or government institutions? Do you improve the supply chain of existing government workflows? Have you worked with the World Bank, State Department, or the UN? These are all valuable experiences that just need to be shaped for USAID’s needs.

USAID staff take international development SERIOUSLY. To get a job with USAID, you often have to have decades of experience living and working overseas and have advanced degrees in international development topics. They are dedicated to international development and it shows.

And nearly everything at USAID has an international development component. The combination of the humanitarian assistance focus, tiny budgets, and working in some of the more remote/unfamiliar parts of the world means that the challenges and priorities faced by USAID may not often be faced in other government programs.

I have witnessed contractors (especially from defense) not take this passion into account and get into hot water by being ignorant of on the ground reality of working in a developing country or be dismissive of the humanitarian focus.

Conversely, I have seen companies move deftly into USAID by attending sessions on development topics and bringing relevant, non-USAID/non-international development experience to the conversation.

In contracting, USAID is more different than similar to other U.S. Government Agencies. Every expert in government contracting I have ever met has told me “Oh, USAID is different. They have their own way of doing things”. Explaining all the areas where this is true would take a book, so suffice it to say, you will probably need a partner who has experience with contracting at USAID to help you respond to RFPs effectively.

The key to getting in the door with USAID is developing relationships with existing implementing partners. The easiest and fastest way to get into USAID is to get a subcontract with an organization currently being funded by USAID. From there, you can build relationships and past performance, and prove that you understand USAID and international development.

USAID uses implementing partners (private U.S.-based and local firms and universities) to deliver its program work, and contractors to support Washington operations. These partners are both non-profits and for-profits and the work is funded through contracts and cooperative agreements.

To get in front of these folks, join advocacy groups such as SBAIC and PSC/CIDC, as well as Society for International Development (SID). Check out Interaction for a great list of US-based international development non-profits (they sometimes use small business subcontractors to help deliver on their cooperative agreements). Make sure you read www.usaid.gov and peruse the DEC (it is a goldmine of historical data!). Keep an eye out for public events on USAID focus areas where you add value; for example, if you know a ton about IT and Health, the mHealth working group sponsored by the K4Health group may be a good use of your time.

Plug into the community and you will find opportunities for your firm to bid and hopefully win a contract or two!

It was a bright morning on April 19 in Maliana town as participants gathered for an unusual meeting. The meeting brought members of Timor-Leste‘s Parliament to the capital of Bobonaro District, southwest of the capital Dili, to hear from members of the public. The public forum was part of USAID’s Fostering Meaningful and Responsive Representation project, implemented by the International Republican Institute (IRI). The project’s activities include support to political parties as they find effective ways to interact with constituents.

Timor-Leste is one of the world’s newest democracies, gaining its independence in 2002. Over the past 11 years, voters have participated in seven free and fair elections, most recently in 2012, when they elected a new president and new Parliament.

Citizens from Bobonaro District, southeast of the capital Dili, voice their opinions and concerns to members of the Timor-Leste Parliament at a USAID-supported public forum in April 2013. Photo credit: Paul Randolph, USAID

Seats in Timor-Leste’s Parliament are party-based, and on election day voters choose a party rather than an individual candidate. Members of Parliament are drawn from the party lists based on what percentage of the popular vote each party received. This means that parliamentarians don’t have specific geographic constituencies.

In every democracy, it’s crucial that parliamentarians meet their constituents regularly to explain how they are serving communities as their elected representatives and listen to the views of citizens to incorporate them into legislation and public policies.

That kind of interaction is often difficult in Timor-Leste, where the population of just over 1 million people is spread across the island in a dozen district capitals, many small towns and scattered rural communities. Roads to the capital are in bad condition and transportation costs are high. It’s often impossible for citizens to make their way to Dili to gain attention for their views and concerns.

With significant transportation challenges and a nationwide constituency, it’s not easy to reach out to citizens to get their input. So the USAID responsive representation project is finding effective ways to increase parliamentarians’ interaction with the public.

One way of facilitating more interaction between parliamentarians and citizens is through a public forum, like the Bobonaro meeting. This was the second in the project’s series of constituency outreach activities focused on “Listening to the People’s Voice.” The series itself is a first for this Parliament.

Parliamentarian Mateus de Jesus (CNRT) shows notes received from constituents during the “Listen to the People’s Voice” forum in Maliana, Timor-Leste, in April 2013. Photo credit: Paul Randolph, USAID

This forum enables members of parliament to meet and interact with citizens outside Dili. They can explain their party’s stance on major issues of public interest and, more importantly, listen to constituents’ viewpoints. In particular, parliamentarians said that they are eager to hear feedback and local concerns because they were just elected in July 2012.

Four parties won seats in Parliament in the 2012 election. Three form the governing coalition: the National Congress of Timor-Leste Reconstruction (CNRT), the Democratic Party (PD), and the National Reconstruction Front of Timor-Leste (Frenti-Mudanca). The Revolutionary Front of Independent Timor-Leste (FRETILIN) is now the opposition party, having governed Timor-Leste from 2002 to 2007. Three of the four parties sent parliamentarians to the public forum.

The 100 participants in Maliana represented a typical cross section of Timorese society – students, teachers, community leaders, representatives from NGOs, women and youth organizations, local offices of political parties, and district offices of government ministries. Participants raised many concerns, including poor rural road conditions, poor quality of small infrastructure projects, a lack of medical supplies at the district hospital, and the need for ambulances. Students highlighted a lack of books in their schools and limited access to scholarships for rural students. Others talked about their concerns related to government social programs, such as pension payments for veterans and the elderly people that do not always reach their recipients. Many voiced their concerns about the government’s plan to adopt and implement a new decentralization policy.

Parliamentarians said that they shared most of the participants’ concerns, and promised to channel those concerns to the relevant government ministries. They also said they would urge the government to address those concerns appropriately.

At the end of the forum, both parliamentarians and participants expressed appreciation for the opportunity to better communicate with each other. After the forum, Mateus de Jesus said this USAID-supported outreach activity was the first such opportunity for the current legislature, helping parliamentarians improve their outreach activities and connecting parliamentarian with their constituents. ” This forum was very important so that we can hear directly from the people living in the districts,” de Jesus said. “As parliamentarians, we’re aware that most of the issues raised during the forum relate to government capacity. However, as representatives of the people, we can channel these concerns to the relevant ministries or departments and demand accountability.”

Timor-Leste’s parliamentarians are demonstrating their commitment to reach out to constituents, helping to fulfill their role of overseeing the executive branch. As one of the participants said, “It’s good that today we have the chance to meet the parliamentarians in the district and convey our concern directly to them, but we hope that parliamentarians will conduct such forums regularly in the future as part of their own agendas, and that they must will their authority to ensure that our concerns are addressed.”

Based on this success, USAID’s representationproject will help expand these opportunities to other districts in the next few months.

I hope that Timor-Leste’s parliamentarians and party benches will continue to schedule more frequent outreach forums themselves and develop their own best strategies for meeting constituents, listening to their feedback, and ensuring that their concerns are addressed appropriately.

As parliamentarians begin to strengthen these kinds of mechanisms, and development partners like USAID continue to assist, I think that it would not be a far-fetched hope that in the future the relationship between Timor-Leste’s parliamentarians and citizens will be as bright as the morning sun that day in Maliana.

In 2009, Secretary Clinton announced that the U.S. State Department would extend benefits to the same-sex partners of Foreign Service officers. Although I didn’t officially begin working for USAID until September 2012, I had applied to the agency’s Development Leadership Initiative program that summer and had little idea just how much this and other policy advancements towards LGBT equality would impact me, my family and my work just a few years later.

My wife and I departed for Nicaragua for my first assignment as a Democracy, Human Rights and Governance Officer in August 2012, having just learned that I was pregnant with our daughter. I had the good fortune of being assigned to a Mission with a long legacy of work with the LGBT community through its HIV/AIDS programming, and an incredibly supportive Ambassador, supervisor and Mission Director (who caught me more than once sleeping under my desk at lunch during those exhausting days of the first trimester). My wife, now considered an “eligible family member” under the new policy, was able to apply for and obtain employment at the Embassy, providing a source of income during my maternity leave.

In December 2012, the Mission leadership passed a Mission Order to provide guidance on further integrating LGBT persons and priorities into its programs, which has served as a model in the region. In February 2013, the interagency LGBT Working Group collaborated to host a half-day workshop at the U.S. Embassy for leaders from the LGBT community in order to better understand their needs and priorities and to inform them of policy changes and upcoming opportunities for U.S. Government support of their work.

Unfortunately, despite advances throughout Latin America towards LGBT equality, the LGBT community in Nicaragua still suffers widespread societal discrimination and gender-based violence, issues that USAID will continue to address through its health and democracy, human rights and governance programming. However, our experience here in the capital of Managua – first as a same-sex couple and now as two proud new mothers – has been nothing but positive, giving me hope that the tides are turning in Nicaragua. While we were likely the first same-sex couple to give birth at the main hospital here in Managua, which caused some confusion at City Hall when picking up our daughter’s birth certificate, our Nicaraguan caregivers, colleagues and friends have greatly enriched our experience, and we are delighted with our decision to remain here for her delivery.

As I write this from Managua with my wife, mother, parents-in-law, and newborn baby girl by my side, the theme of this year’s International Day of Families, “Advancing Social Integration and Intergeneration Solidarity,” feels especially appropriate. Not only am I privileged to work for an agency that recognizes the value and importance of advancing the integration of LGBT families both within the agency and in its programming, but I am blessed that our little one has three grandparents and two great-grandparents who embrace and celebrate the diversity of our family almost as much as they celebrate her arrival.

Recently, while visiting the West Bank, I had the pleasure to meet Palestinian shop owner Abu Shadi at his store in the community of Dura in the Hebron governorate. His Al Awawdeh Shop is one of 130 West Bank shops participating in an innovative USAID/World Food Programme (WFP) food assistance voucher program that channels aid through the local market.

Introduced in the West Bank in 2009, the voucher program now covers 86,000 West Bank beneficiaries, including 63,000 who are covered through USAID support.

As Abu Shadi explained, his customers, fellow shop owners and local farmers, all benefit from this relatively new way of delivering food assistance. The voucher program allows families to choose from a selection of staple foods, including bread, milk, yogurts, cheese, eggs, beans, lentils, vegetable oil and salt with an electronic card, similar to a debit card. They have more choice in what they can buy, the food is fresh, and they are injecting money directly into the Palestinian economy by supporting more local producers, farmers and shopkeepers.

One voucher card user told our WFP colleagues that, “For a very long period we could not afford to buy eggs, milk and other dairy products. Thanks to the voucher program, my children now eat eggs and cheese regularly. They have become so much more active and full of energy now.”

To the extent possible, all of these goods come from local producers and are delivered through the normal private sector supply chain to the shops – giving the private sector a role in delivering the food assistance and also saving the donors the high costs of shipping and delivering the food commodities. Abu Shadi’s shop currently redeems vouchers for 113 households, or about 874 people. With the increased business he has seen thanks to this program, he has hired an additional worker for the store.

Abu Shadi proudly told us, “I am very happy being part of this project. I hope we can reach and include other stores in the community, so they can get the same benefits I have received. I doubled my income and now have a steady income for myself and my married son. It also gave me the opportunity to expand my store.”

Like all stores participating in the program, Abu Shadi’s store is registered with the Palestinian Authority (PA) tax authorities, which strengthens the PA’s ability to collect taxes. The stores also meet a set of standards required from all stores in the program. These stores must maintain refrigeration to keep the foods fresh and safe for consumers, maintaining Internet connectivity so that WFP can instantly track voucher redemptions, and guaranteeing a constant stock of all food products included in the program.

A voucher user explains to AAA Romanowski which products she buys using the USAID/WFP voucher system. Photo credit: WFP/Quique Kierszenbaum

“It was really fantastic to see how adjusting our way of delivering assistance has made such a difference for the local community,” one mother explained. “My daughter suffers from rickets and our doctor has been advising us for a long time to give her milk and yogurt daily. We couldn’t afford to do that. Thanks to the voucher program, we can now provide our daughter with the food she needs.”

Overall, USAID helps WFP and its implementing partner CHF to provide food and voucher assistance to vulnerable, non-refugee families in the West Bank and Gaza. Currently the USAID-funded caseload includes 203,000 individuals in the West Bank and Gaza. The United States also is the largest bilateral donor to UNRWA, which provides food assistance to nearly 750,000 Palestinian refugees and supplemental school feeding to more than 223,000 children in Gaza; aid to 52,000 food insecure persons in the West Bank; and food relief to 290,000 other vulnerable Palestinian refugees across the Middle East.

As President Obama noted in his recent proposal to reform U.S. food assistance, voucher programs are a cost effective way to provide many vulnerable families with the food assistance they most need while simultaneously creating much-needed employment opportunities for local economies.

During the month of May, we have been highlighting USAID’s work in Global Health. Global health plays a critical role in ending extreme poverty — with a particular focus on ending preventable child and maternal deaths, and creating an AIDS-free generation. The first part of the month, from May 1-10, we focused on the role that science, technology and innovation plays in global health. In celebration of mothers everywhere, we will be featuring the important role of mothers and partnerships in Global Health during May 11-17. Future highlights include AIDS-Free Generation (May 18-27), Family Planning (May 27-June 2), Nutrition (June 3-8). Photo is from PATH/Satvir Malhotra.

Follow USAID for Global Health (@USAIDGH) on Twitter and use #GHMatters to join in the conversation.